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Predictors of Mammography Uptake Among Italian Women Aged 50–69: a Cross-sectional Study

  • Brigid Unim
  • Roberto Boggi
  • Massimo Napoli
  • Roberta Fulgenzi
  • Adelaide Landi
  • Giuseppe La TorreEmail author
Article
  • 12 Downloads

Abstract

Screening coverage is of concern in several countries, including Italy. The aim of the study is to assess predictors of participation in the mammography screening program at the Local Health Unit RMA (Rome, Italy). A telephone-based questionnaire was administered to randomly selected eligible women. The study population was interviewed by the personnel of the health center. Five hundred two women were interviewed, of which 264(52.6%) have attended the breast cancer screening program at least once. The attendees received the invitation letter more often than the non-attendees (88.3% vs. 77.7%; p = 0.002) and were more willing to participate (85.6% vs. 69.3%; p < 0.001). Employees were more among the non-attendees of the screening program (66% vs. 52.3%; p = 0.002). Age over-61 (OR = 2.75; 95%CI 1.84–4.09), receiving the invitation letter (OR = 2.54; 95%CI = 1.52–4.24), and intention to participate (OR = 3.09; 95%CI = 1.94–4.91) were significantly associated with participation in the screening program. Although the invitation rate of the Local Health Unit RMA has improved in recent years, the mammography uptake rate remains very low. The presence of opportunistic screening activities, younger age, and low educational status could explain the low participation rates. Organizational barriers (e.g., screening hours coinciding with work hours, screening facilities located far away) may also limit participation. Major efforts should be made towards the regulation of opportunistic screening activities and reorganization of the screening centers and communication strategies to better comply with the needs of the target population. In this light, the involvement of different healthcare professionals, especially general practitioners, and gynecologists, is crucial.

Keywords

Screening Mammography Breast cancer Attendance rate 

Notes

Compliance with Ethical Standards

Conflict of Interests

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Teaching Hospital Umberto I of Rome Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al (2012) Globocan v1.0, cancer incidence and mortality worldwide: IARC cancerbase no. 11. http://globocan.iarc.fr/Default.aspx. Accessed 7 Feb 2018
  2. 2.
    Aznan MS, Razrim R, Affirul CA, Rohaizak M (2015) Male ductal carcinoma in situ (DCIS): treatment strategies in this rare entity. Clin Ther 166(5):e327e9Google Scholar
  3. 3.
    Associazione italiana Registri Tumori (2014) I numeri del cancro in Italia. http://www.registri-tumori.it/PDF/AIOM2014/I_numeri_del_cancro_2014.pdf. Accessed 7 Feb 2018
  4. 4.
    Hall PS, Hamilton P, Hulme CT, Meads DM, Jones H, Newsham A, Marti J, Smith AF, Mason H, Velikova G, Ashley L, Wright P (2015) Costs of cancer care for use in economic evaluation: a UK analysis of patient-level routine health system data. Br J Cancer 112:948–956CrossRefGoogle Scholar
  5. 5.
    Blumen H, Fitch K, Polkus V (2016) Comparison of treatment costs for breast cancer, by tumor stage and type of service. Am Health Drug Benefits 9(1):23–32Google Scholar
  6. 6.
    Carrieri V, Wuebker A (2016) Quasi-experimental evidence on the effects of health information on preventive behaviour in Europe. Oxf Bull Econ Stat 78(6):765–791CrossRefGoogle Scholar
  7. 7.
    OECD, Health at a glance (2017) OECD indicators. OECD Publishing, Paris.  https://doi.org/10.1787/health_glance-2017-en. Accessed 15 Feb 2018
  8. 8.
    Decreto del presidente del consiglio dei ministri (DPCM) 29 novembre (2001) Definizione dei livelli essenziali di assistenza. Gazzetta Ufficiale n. 33 del 08 febbraio 2002 [Decree of the President of the Council of Ministers 29 November (2001) Definition of basic healthcare parameters. Official Gazette of the Italian Republic n.33 of February 8th, 2002]Google Scholar
  9. 9.
    Giordano L, Castagno R, Giorgi D, Piccinelli C, Ventura L, Segnan N et al (2015) Breast cancer screening in Italy: evaluating key performance indicators for time trends and activity volumes. Epidemiol Prev 39(3 Suppl 1):30–39Google Scholar
  10. 10.
    Italian National Health Institute-ISS (2017) Breast screening in Italy. http://www.epicentro.iss.it/passi/dati/ScreeningMammografico.asp. Accessed 15 Feb 2018
  11. 11.
    Regione Lazio: Screening della mammella. http://www.regione.lazio.it/screening/dati_mammo.html. Accessed 18 Feb 2018
  12. 12.
    Unim B, Boggi R, Napoli M, Fulgenzi R, Landi A, La Torre G (2018) Women’s satisfaction with mammography and predictors of participation in an organized breast cancer screening program: perspectives of a local health unit in Rome. Public Health 155:91–94CrossRefGoogle Scholar
  13. 13.
    Hosmer DW, Lemeshow S (2000) Applied logistic regression, 2nd edn. Wiley, New YorkCrossRefGoogle Scholar
  14. 14.
    Almog R, Hagoel L, Tamir A, Barnett O, Rennert G (2008) Quality control in a national program for the early detection of breast cancer: women’s satisfaction with the mammography process. Womens Health Issues 18(2):110–117CrossRefGoogle Scholar
  15. 15.
    Molina-Barceló A, Salas Trejo D, Miranda García J (2011) Women’s satisfaction with waiting times for further investigation in breast cancer screening. Gac Sanit 25(5):357–362CrossRefGoogle Scholar
  16. 16.
    Giordano L, Stefanini V, Senore C, Frigerio A, Castagno R, Marra V, Dalmasso M, del Turco MR, Paci E, Segnan N (2012) The impact of different communication and organizational strategies on mammography screening uptake in women aged 40-45 years. Eur J Pub Health 22(3):413–418CrossRefGoogle Scholar
  17. 17.
    Grazzini G, Zappa M (2008) Attendance in cancer screening programmes in Italy. Ital J Public Health 5(2):117–124Google Scholar
  18. 18.
    Purnell JQ, Thompson T, Kreuter MW, McBride TD (2015) Behavioral economics: “nudging” underserved populations to be screened for cancer. Prev Chronic Dis 12:E06Google Scholar
  19. 19.
    Giordano L. Breast cancer screening experiences on communication from Italy. https://www.osservatorionazionalescreening.it/sites/default/files/allegati/11_Giordano%20CommunicationWHITE_BO_30Jan2014.pdf. Accessed 10 Apr 2018
  20. 20.
    Peipins LA, Shapiro JA, Bobo JK, Berkowitz Z (2006) Impact of women’s experiences during mammography on adherence to rescreening (United States). Cancer Causes Control 17(4):439–447CrossRefGoogle Scholar
  21. 21.
    Devaux M (2015) Income-related inequalities and inequities in health care services utilization in 18 selected OECD countries. Eur J Health Econ 16(1):21–33CrossRefGoogle Scholar
  22. 22.
    McMorrow S, Kenney GM, Goin D (2014) Determinants of receipt of recommended preventive services: implications for the affordable care act. Am J Public Health 104(12):2392–2399CrossRefGoogle Scholar
  23. 23.
    Altobelli E, Lattanzi A (2014) Breast cancer in European Union: an update of screening programmes as of March 2014 (review). Int J Oncol 45(5):1785–1792CrossRefGoogle Scholar

Copyright information

© American Association for Cancer Education 2019

Authors and Affiliations

  • Brigid Unim
    • 1
  • Roberto Boggi
    • 2
  • Massimo Napoli
    • 2
  • Roberta Fulgenzi
    • 2
  • Adelaide Landi
    • 2
  • Giuseppe La Torre
    • 1
    Email author
  1. 1.Department of Public Health and Infectious DiseasesSapienza University of RomeRomeItaly
  2. 2.Local Health Unit ASL Roma A, Department of Prevention - Hygiene and Public Health ServiceRomeItaly

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